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Summary

Mel Herbert, MD MBBS FAAEM and Stuart Swadron, MD, FRCPC
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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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EM:RAP 2018 04 April Written Summary 535 KB - PDF

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ryan harris -


Would you consider a short segment on US assessment of IJ for fluid responsiveness?

I can't remember where I got this article (maybe it was EMRAP and I'm forgetting). It contends that IVC measure is bunk and some fancy LVOT measurement and IJ measurements combination perform best. The two IJ measurements are 0 and 90 variation and just respiratory variation at 90 deg. Doesn't that sound great to just do a respiratory variation at 90 on someone's neck rather than fishing around their abdomen for the best view. The fancy LVOT measurement seems like it would be beyond most providers looking for a quick answer about fluid responsiveness.

What do your US experts say?

I sure would love them to say, use the right IJ with pt sitting up :)

Thanks,
Ryan
PS thanks for doing the segment on the IO lidocaine. Ask and ye shall receive.

there are two articles links pasted in below. One is from ACEP tips and tricks on the IJ and the second is the surgery article
1. https://www.acep.org/_Ultrasound-Section-Microsite/Tips---Tricks--Volume-Status---Using-the-Internal-Jugular-Vein/#sm.0001yjphbg7qpek0r7y2h4xv817kr

2.
Ultrasound assessment of volume responsiveness in critically ill surgical patients: Two measurements are better than one
Murthi, Sarah B. MD; Fatima, Syeda RDCS; Menne, Ashely R. MD; Glaser, Jacob J. MD; Galvagno, Samuel M. DO, PhD; Biederman, Stephen MD; Fang, Raymond MD; Chen, Hegang PhD; Scalea, Thomas M. MD

Journal of Trauma and Acute Care Surgery: March 2017 - Volume 82 - Issue 3 - p 505–511

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